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The role of team members can be flexible to meet the needs of particular
communities. The individual abilities of members should be tapped to enhance
team effectiveness. Each member should:
·
Contribute information from his or her records.
·
Serve
as a liaison to respective professional counterparts.
·
Provide
definitions of professional terminology.
·
Interpret agency procedures and policies.
·
Explain
the legal responsibilities or limitations of his or her profession.
They should also assist with referrals for services or provide direct aid to
surviving family members. All team members must have a clear understanding of
their own and other professional and agency roles and responsibilities in their
community's response to child fatalities. In addition, team members need to be
aware of and respect the expertise and resources offered by each profession and
agency. The integration of these roles is key to well coordinated community
child death response systems.
1.
The Medical Examiner
Medical examiners are central to the functions of both child death review teams
and child death investigations. State law requires that all unexpected child
deaths be reported to and investigated by a county medical examiner. In
Michigan, medical examiners are physicians. Medical examiners have the
responsibility and the right to determine cause and manner of death. Medical
examiners lay the groundwork for discussion by presenting basic information
about cause and manner of death, including findings from the scene
investigation, autopsy and medical history. Medical examiners can legally obtain
records from other investigating agencies. Medical examiners have the right to
access information from police, paramedics, hospitals, CPS and others to
determine cause of death. Usually, no other agency has such wide latitude. The
county prosecutor’s office can obtain these records, but only for deaths the
office is pursuing for criminal prosecution. The medical examiner’s office can
obtain such records for any death, whether due to homicide, accident, suicide,
or natural causes. Medical examiners can also interpret clinical findings and
provide additional details that help teams better understand a cause of death
ruling.
2.
Law Enforcement
Law enforcement team members provide information on criminal investigations of
child deaths under team review. They also check criminal histories of children
and/or family members and of suspects in intentional child death cases. To
ensure sufficient representation, both the sheriff's department and the police
department with the largest jurisdictions should have members on the team. Law
enforcement team members serve as liaisons between the team and other local law
enforcement departments. They assist in persuading officers from other agencies
to participate in reviews of deaths in their jurisdictions. Law enforcement
professionals are usually the team members best trained in scene investigation
and interrogation, essential skills for determining how a child died. Such
expertise provides useful information and training to other members.
3.
Department of Human Services
DHS has the legal authority and responsibility to investigate child deaths and
to provide protection to siblings who might be at risk. As team members, DHS
representatives can provide detailed information on families and on their
investigations into child deaths. DHS may have prior agency contact information
including reports of neglect or abuse on a child or siblings, and of services
previously or currently provided to a family. They may be able to provide
information on a family's history and sociological factors that influence family
dynamics, such as unemployment, divorce, previous deaths, history of domestic
violence or drug abuse, and previous child abuse. When reviews indicate a need,
DHS representatives can provide services to surviving family members. Their
knowledge on issues related to child abuse and neglect cases is essential to
team effectiveness.
4.
Prosecuting Attorney
Prosecutors educate child death review teams on criminal law and provide
information about criminal and civil actions taken against those involved in the
child deaths reviewed. They can also explain when a case can or cannot be
pursued and provide information about previous contact or criminal prosecutions
of family members or suspects in child deaths.
5.
Public Health
Public health agencies facilitate and coordinate preventive health services and
community health education programs. Public health child death review team
members can provide vital records and epidemiological risk profiles of families
for early detection and prevention of child deaths, as well as information on
county public health services. Public health doctors or nurses help identify
public health issues that arise in child deaths and provide medical
explanations. If a child was treated in a local public health facility or
received home visits, they can provide medical histories and explain previous
treatments, especially helpful in the review of infant deaths. Many local public
health agencies can provide information on risk factors and services available
to high risk pregnant women and their families.
6. Pediatrician
Pediatricians provide child death review teams with medical explanations and the
benefit of their perspective, gained by having examined thousands of living
children. They can access medical records from hospitals and from other doctors.
If a pediatrician testifies regularly in child abuse trials, his or her expert
opinion regarding medical evidence can be useful. It is preferable to have
pediatrician team members experienced in treating victims of child abuse and
neglect. If a pediatrician is unavailable, teams can select a physician who
specializes in family practice or has a general practice.
7.
Emergency Medical Services
EMS is frequently first at the scene and observes critical information regarding
the scene and circumstances of a child death, including the behavior of
witnesses. The EMS run report can also be useful in determining body position at
death and identification of other evidence that may have been moved before an
investigator’s arrival at a scene. EMS also has well established relationships
with local hospitals and can provide a perspective from these agencies.
8. Hospitals
Local hospital representatives on child death review teams can be emergency room
staff, quality assurance officers, social workers or key administrators. Their
participation can facilitate the sharing of medical records with a team. When a
child is transported to an emergency room, hospital representatives can provide
a review team with pertinent information. They can also obtain valuable
information from reviews to help improve hospital practices.
9. Community Mental
Health
The mental health representative on a child death review team provides
information and insight regarding psychological issues related to events that
caused a child death. Although federal guidelines preclude community mental
health from sharing case-specific information unless consent is obtained, they
can suggest when counseling or other mental health service referrals may be
appropriate. Their participation at the review can provide valuable insight into
their own agency policies and practices.
10. Probate or
Family Court
Juvenile probation officers can provide child death review teams with
information on crimes and delinquencies involving older children. A large number
of teenagers die as a result of suicide and homicide. Records from juvenile
probation workers can assist in reviews of such deaths. The court can also
provide information related to child abuse and neglect. The courts can also
learn from reviews and improve child protection and juvenile court proceedings.
11. Educators
Educators can provide child death review teams with perspective on child health,
growth and development. Although federal laws preclude educators from sharing
student case records with review teams, their
presence at reviews
enhances the delivery of support services and interventions. This is especially
true in cases of traumatic death, particularly in developing school support
services in the event of suicides and homicides. The schools are also able to
provide leadership in implementing review team prevention recommendations. |